Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, BC, Canada; Department of Psychology, 9 Campus Drive, 154 Arts, University of Saskatchewan, Saskatoon S7N 5A5, SK, Canada.
Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, BC, Canada.
Horm Behav. 2017 Nov;96:69-83. doi: 10.1016/j.yhbeh.2017.09.005. Epub 2017 Sep 19.
Hippocrates attributed women's high emotionality - hysteria - to a 'wandering womb'. Although hysteria diagnoses were abandoned along with the notion that displaced wombs cause emotional disturbance, recent research suggests that elevated levels of oxytocin occur in both bipolar disorder and endometriosis, a gynecological condition involving migration of endometrial tissue beyond the uterus. We propose and evaluate the hypothesis that elevated oxytocinergic system activity jointly contributes to bipolar disorder and endometriosis. First, we provide relevant background on endometriosis and bipolar disorder, and then we examine evidence for comorbidity between these conditions. We next: (1) review oxytocin's associations with personality traits, especially extraversion and openness, and how they overlap with bipolar spectrum traits; (2) describe evidence for higher oxytocinergic activity in both endometriosis and bipolar disorder; (3) examine altered hypothalamic-pituitary-gonadal axis functioning in both conditions; (4) describe data showing that medications that treat one condition can improve symptoms of the other; (5) discuss fitness-related impacts of endometriosis and bipolar disorder; and (6) review a pair of conditions, polycystic ovary syndrome and autism, that show evidence of involving reduced oxytocinergic activity, in direct contrast to endometriosis and bipolar disorder. Considered together, the bipolar spectrum and endometriosis appear to involve dysregulated high extremes of normally adaptive pleiotropy in the female oxytocin system, whereby elevated levels of oxytocinergic activity coordinate outgoing sociality with heightened fertility, apparently characterizing, overall, a faster life history. These findings should prompt a re-examination of how mind-body interactions, and the pleiotropic endocrine systems that underlie them, contribute to health and disease.
希波克拉底将女性的高度情绪化——歇斯底里——归因于“游走的子宫”。虽然随着子宫位置异常导致情绪紊乱这一观点的摒弃，歇斯底里的诊断也被放弃，但最近的研究表明，在双相情感障碍和子宫内膜异位症中，催产素水平升高，而子宫内膜异位症是一种涉及子宫内膜组织迁移到子宫外的妇科疾病。我们提出并评估了这样一个假设，即升高的催产素能系统活性共同导致了双相情感障碍和子宫内膜异位症。首先，我们提供了有关子宫内膜异位症和双相情感障碍的相关背景，然后检查了这两种疾病之间的共病证据。接下来：（1）回顾催产素与人格特质的关系，特别是外向性和开放性，以及它们如何与双相谱特质重叠；（2）描述催产素活性在子宫内膜异位症和双相情感障碍中升高的证据；（3）检查这两种情况下下丘脑-垂体-性腺轴功能的改变；（4）描述数据表明，治疗一种疾病的药物可以改善另一种疾病的症状；（5）讨论子宫内膜异位症和双相情感障碍的与适应度相关的影响；（6）回顾多囊卵巢综合征和自闭症这两种情况，它们显示出涉及催产素能活性降低的证据，与子宫内膜异位症和双相情感障碍形成直接对比。综合考虑，双相谱和子宫内膜异位症似乎涉及女性催产素系统中失调的高度适应性多效性，即催产素能活性升高协调外向社交性和更高的生育能力，总体上，表现出更快的生活史。这些发现应该促使重新审视身心互动以及构成它们的多效性内分泌系统如何促进健康和疾病。
